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Int J Cardiovasc Imaging (2013) 29:753764 DOI 10.1007/s10554-012-0136-z
ORIGINAL PAPER
Beat to beat 3-dimensional intracardiac echocardiography: theoretical approach and practical experiences
Daniel Stapf Andreas Franke Marcus Schreckenberg
Georg Schummers Karl Mischke Nikolaus Marx
Patrick Schauerte Christian Knackstedt
Received: 4 June 2012 / Accepted: 3 October 2012 / Published online: 14 October 2012 Springer Science+Business Media Dordrecht 2012
Abstract Three-dimensional (3D)-imaging provides important information on cardiac anatomy during electrophysiological procedures. Real-time updates of modalities with high soft-tissue contrast are particularly advantageous during cardiac procedures. Therefore, a beat to beat 3D visualization of cardiac anatomy by intracardiac echocardiography (ICE) was developed and tested in phantoms and animals. An electronic phased-array 510 MHz ICE-catheter (Acuson, AcuNavTM/
Siemens Medical Solutions USA/64 elements) providing a 90 sector image was used for ICE-imaging. A custom-made mechanical prototype controlled by a servo motor allowed automatic rotation of the ICE-catheter around its longitudinal axis. During a single heartbeat, the ICE-catheter was rotated and 2D-images were acquired. Reconstruction into a 3D volume and rendering by a prototype software was performed beat tobeat.After experimentalvalidationusinga rigidphantom,the system was tested in an animal study and afterwards, for quantitative validation, in a dynamic phantom. Acquisition of beat to beat 3D-reconstruction was technically feasible. However, twisting of the ICE-catheter shaft due to friction and torsion was found and rotation was hampered. Also, depiction of
catheters was not always ensured in case of parallel alignment. Using a curved sheath for depiction of cardiac anatomy there was no congruent depiction of shape and dimension of static and moving objects. Beat to beat 3D-ICE-imaging is feasible. However, shape and dimension of static and moving objects cannot always be displayed withnecessary steadiness as needed in the clinical setting. As catheter depiction is also limited, clinical use seems impossible.
Keywords Intracardiac echocardiography
Three-dimensional Real-time Cardiac imaging
Catheter ablation
AbbreviationsAF Atrial brillationCT Computed tomographyGPU Graphics processing unitICE Intracardiac echocardiography MRI Magnetic resonance imagingPV Pulmonary veinTEE Transesophageal echocardiography 2D/3D/4D Two-/three-/four-dimensional
Introduction
Ablation therapy currently provides a therapeutic approach for many rhythm disturbances [1]. These techniques are based on electrocardiogram information and additionally on anatomical landmarks. Particularly ablation of complex arrhythmias e.g. atrial brillation (AF) and ventricular tachycardias require detailed information oncardiac anatomy as these arrhythmias often originate around anatomical structures like orices of the pulmonary veins...